Nawaz Hafiz Awais, Khan Tahir Mehmood, Adil Qendeel, Goh Khang Wen, Ming Long Chiau, Blebil Ali Qais, Lee Kah Seng, Dhaliwal Jagjit Singh
Institute of Pharmaceutical Sciences, University of Veterinary & Animal Sciences, Lahore 54000, Pakistan.
School of Pharmacy, Monash University Malaysia, Bandar Sunway 47500, Malaysia.
Pediatr Rep. 2022 Jun 15;14(2):312-319. doi: 10.3390/pediatric14020038.
Several studies have shown that polypharmacy is the main cause of drug interactions, and the prevalence and the level of the severity varied with the duration of stay in the hospital, sex and race of the patients. The aims of this investigation were to identify the drug-drug interactions in hospitalized pediatric patients associated with polypharmacy, and to categorize the drug interactions in pharmacokinetic or pharmacodynamic interactions according to their level of severity.
A cross-sectional, prospective analytical study was performed at a pediatric tertiary care hospital in Lahore, Pakistan for the duration of 4 months, which included prescription orders for 300 patients. Data were collected from patient medical files about previous and current medication history. Drug interactions were analyzed using interaction checker on Medscape and categorized according to the severity levels.
Out of 300 patients, the occurrence of drug interactions was found in 157 (52.3%) patients, while in 143 (47.7%), no interaction was found. Among these interactions, 50.7% were pharmacodynamic interactions, and 49.30% were pharmacokinetic interactions. Eighty-one percent of prescription orders with drug interactions contained more than three drugs, and 11.9% of interactions were severe. The majority of interactions were of amikacin-vancomycin, piroxicam-captopril and captopril-ciprofloxacin.
Most of the interactions were moderate among patients with multiple drug prescriptions. The drug interactions can be minimized by providing special patient monitoring and adequate management with prior knowledge of these drug interaction.
多项研究表明，联合用药是药物相互作用的主要原因，其发生率和严重程度因患者住院时间、性别和种族而异。本研究的目的是确定住院儿科患者中与联合用药相关的药物相互作用，并根据严重程度将药物相互作用分为药代动力学或药效学相互作用。
在巴基斯坦拉合尔的一家儿科三级护理医院进行了一项为期4个月的横断面前瞻性分析研究，纳入了300例患者的处方医嘱。从患者病历中收集有关既往和当前用药史的数据。使用Medscape上的相互作用检查器分析药物相互作用，并根据严重程度进行分类。
在300例患者中，157例（52.3%）患者发生了药物相互作用，143例（47.7%）未发现相互作用。在这些相互作用中，50.7%是药效学相互作用，49.30%是药代动力学相互作用。81%有药物相互作用的处方医嘱包含三种以上药物，11.9%的相互作用为严重相互作用。大多数相互作用发生在阿米卡星-万古霉素、吡罗昔康-卡托普利和卡托普利-环丙沙星之间。
在开具多种药物处方的患者中，大多数相互作用为中度。通过提供特殊的患者监测并在事先了解这些药物相互作用的情况下进行适当管理，可以将药物相互作用降至最低。
